Past, Present and Future Me

Today’s topic is kind of only circumferentially related to medicine, and more relates to my past expectations.

Also, apologies if the site was loading slowly recently. I think the new Twitter widget was slowing things down. I have since removed it because I feel speed is more important. For those interested in my twitter, you can just click the link at the top. I tend to reply to med students and residents, mostly with GIFs.

In previous posts, I’ve talked about how my priorities and expectations have changed significantly from when I was medical student. For example, my choice in Cars.

Let’s jump back to the days of medical student Sensei:

Back in 2003 I was a naive young medical student. Since before I could remember, I wanted to be a doctor. And then for some reason, that narrowed down to wanting to be a pediatrician. As to whether this was my own decision or not I’m not really sure. However, since I was around 7 or 8 years old, the idea that I would be a pediatrician like Benjamin Spock was pretty much decided.

This did not change during the first and second years of medical school. To be honest, looking back at it, I had very little knowledge of the vast array of specialties available in medicine. Of course, I had heard of “heart surgeon” and “brain surgeon” and such. I just wanted to be a doctor, I’d figure out the type later, right?

This was completely different from one of the other pre-meds from when I was back at Berkeley. There was a very intelligent guy in my “shadow a physician” class who already knew he wanted to be a radiologist. I was about 20 at the time and did not even know what a radiologist was. I, of course, was shadowing a pediatrician and I enjoyed it. At the time I didn’t think much of it. However, now that I am older and wiser, this guy know a ton more about being a doctor than I did. My knowledge of being a doctor was very superficial compared to his. Perhaps some of this is because neither of my parents are doctors, and there were no doctors in my immediate or extended family.

As such, when going through my clinical rotations, after deciding I didn’t want to do pediatrics, I struggled to look for “my calling”. Despite having heard of radiology back in college, it never clicked in my head to even “try it out”. It took an astute neurology attending to point it out to me:

“So, what are you applying for?”

“Neurology, actually.”

“Oh no, you’re not a neurologist. You like looking at the MRIs. You’re a radiologist.”

This conversation literally changed my life.

It was like someone slapped me in the face and said, “What are you doing dummy?!” For some reason, I had subconsciously kept steering myself away from Radiology because I had already dismissed it in my head as not having enough patient interaction.

After this conversation with my attending, I changed a few electives around and did a rotation in radiology, and that was it. This is what I wanted. It was going to be hard for me since I was from a Caribbean Medical School, but I knew what I wanted now. This, along with support from my beautiful girlfriend (now beautiful wife) pushed me to “go for it”. I was so determined, that I was ok with going unmatched for a few rounds if necessary to get it.

Denial is not just a river in Egypt.

So back to college past me:

I was woefully unprepared to be a doctor, or even to decide to be a doctor.

Looking back on it now I had very little knowledge of medicine, aside from my superficial experience shadowing a pediatrician in an outpatient setting. If current me was talking to past me, or even another pre-med I would tell myself (and them) that they need more experience. The problem is, how do you get it? I felt I was pretty lucky to get to take a class which matched up practicing physicians with pre-meds. I would have been even less aware of what being a doctor entailed than I already did if this option wasn’t available to me. But:

It’s not nearly enough.

Where can we help these young pre-meds get the experience(s) they need to truly understand whether medicine is their calling? It’s not easy.

Merely “volunteering” at a hospital, while sounding nice on paper, is really just you helping out “where you can”. It doesn’t provide any real clinical experience.

Shadowing a physician is great, but for the most part is only a superficial understanding of life as a doctor.

So what do we do?

Every pre-med needs mentor. A good one. One who will tell you about all of medicine. The good. The bad. The ugly. The work. The call. The pay. The loans. Everything.

One that will help you gain real clinical experience in settings that make you uncomfortable.

Past me would have loved to have had the present me to tell them of everything it is to be a doctor. I could have told them what I wrote here Would you do it again?

This is one of the major reasons I write this blog, to guide and shape future physicians.

What about pre-meds with physician parents?

Pre-meds who have physician parents are lucky in the sense that they have someone currently in the medical field to guide them. However, there is a significant age disparity.

For example, I am 35, my daughter is 3 and my son is 1. By the time they are in high school, 15 years will have passed… and 20+ years from when I was in medical school. A lot can change in 20 years, especially in medicine. If you would believe these startup CEOs, by the time my daughter and son were to go to college, all doctors would be replaced by Artificial Intelligence in Medicine.

The current medical environment from when I was a medical student to now is already pretty significantly different:

Student loans have skyrocketed. Duty hours have changed. The number of residency spots have stayed the same while the number of medical schools have increased.

The way I did things may not work for the current medical students. Their experience(s) will be different.

However, in terms of mentorship, my age range is probably the best bet. Close enough to the end of residency/fellowship to still be relevant, but enough experience as an attending to be able to share our knowledge and experiences. The problem is, for my age/experience group, these young attendings are starting families, trying to pay down their massive student loans as well as working long hours.

There isn’t enough time.

Or… at least it seems like there isn’t.

Let’s try to fix this.

Present me needs to guide the past me so that future me is the best me I can be.

TL;DR

Medicine continues to change.

We need to teach pre-meds what medicine really entails… earlier.

Shadowing and volunteering are great. However, a strong mentorship is better.

Present me needs to guide the past me so that future me is the best me I can be.

-Sensei

Agree? Disagree? Questions, Comments and Suggestions are welcome.

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